A-Z Health Topics

Esophageal Varices

Definition

The esophagus connects the mouth to the stomach. Esophageal varices are abnormally swollen veins within the lining of the esophagus. If undiagnosed or untreated, esophageal varices can rupture and lead to life-threatening bleeding.

Causes

Increased pressure in the veins that deliver blood to the liver is known as
portal hypertension
. The increased pressure causes blood to back up into other smaller vessels, including those of the esophagus. This leads to the formation of esophageal varices.

The medical conditions that lead to the development of portal hypertension and esophageal varices include:

Risk Factors

Symptoms

Esophageal varices are usually only diagnosed when bleeding occurs. Though bleeding from esophageal varices may not be severe and may stop on its own, first-time bleeding events may result in death in some cases.

Signs of bleeding from esophageal varices include:

Vomiting or coughing up blood

Red, tarry, or very dark stools

Low blood pressure

Lightheadedness

Rapid heartbeat

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Endoscopic Band Ligation

Balloon Tamponade

This procedure involves the passage of a balloon through the nose to help compress the bleeding varices.

Sclerotherapy

During
sclerotherapy
, drugs intended to slow bleeding are injected into the bleeding vein and sometimes into the surrounding area. The drugs cause clots to form and harden the vein to stop bleeding.

Transjugular Intrahepatic Portosystemic Shunting (TIPS)

TIPS involves threading a catheter from a neck vein to the liver. A stent, a small tube designed to keep veins open, is bound to the catheter and inserted into the liver. It will increase blood flow through the portal vein and relieve blood pressure in the esophageal varices.
This procedure can control bleeding in most cases.

Distal Splenorenal Shunt (DSRS)

DSRS is a surgical procedure that connects the main vein in the spleen to the left kidney vein. The procedure is done to lower blood pressure in the swollen vessels and to limit bleeding.

Esophageal Transection

This procedure is reserved for patients who fail to respond to drug or endoscopic treatment and are not considered good candidates for a shunting procedure.

Liver Transplant

Liver transplantation is the only way to completely cure esophageal varices.

Prevention

To help reduce your chances of getting esophageal varices, take these steps:

Seek immediate treatment for long-term alcohol abuse.

Tell your doctor if you are at risk for chronic liver disease, blood clots, or are on medications that may damage the liver.

If you already have chronic liver disease, your doctor may prescribe drugs to prevent swollen vessels from developing.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.